Chronic Kidney Disease in Acute Coronary Syndromes: real-world Data of long-term Outcomes

Abstract

Aim: Patients with chronic kidney disease (CKD) are at increased cardiovascular risk. Methods: Patients with acute coronary syndrome were retrospectively allocated to three groups (stage 3A, stage 3B or stage 4) based on the Kidney Disease Improving Global Outcomes classification formulas: the CKD Epidemiology Collaboration (CKD-EPI; N = 401) and the modification of diet in renal disease (n = 355). The primary end point was all-cause mortality (median follow-up time, 32 months [ 15–70 ]). Results: Study results showed decreased median survival was associated with poor renal function for both the CKD-EPI (78 vs 61 vs 40 months, p = 0.014) and modification of diet in renal disease groups (68 vs 57 vs 32 months, p = 0.006). After adjustment, age (OR: 1.07; 95% CI: 1.01–1.14) and pulmonary artery systolic pressure (OR: 1.08; 95% CI: 1.03–1.14), but not estimated glomerular filtration rate, were associated with decreased survival. Conclusion: Study results suggest that poor outcomes after an acute coronary syndrome were associated with comorbidities rather than estimated glomerular filtration rate level.

Kidney Disease as Risk of In-Hospital Mortality in Patients With Acute Coronary Syndrome

“…However, few studies show kidney disease as an indicator of mortality in patients presenting with ACS. Recently, a study found a correlation between CKD and a worse long-term prognosis in ACS [8], although when adjusted for other confounders, the association was not clinically important.…”